Patterns of Change During the Dermoscopic Follow-Up of Melanocytic Lesions in High Risk Patients

Melanomas and melanocytic nevi that change over time display different change patterns, correlated with histopathological features. We performed a retrospective analysis of the dermoscopic images corresponding to 86 lesions excised due to the changes occurred during the follow-up period in patients at high risk for melanoma, and we drew a comparison between the changes occurring in melanomas and those occurring in melanocytic nevi. There were significant differences between the models of dermoscopic change characteristic to melanoma and those characteristic to melanocytic nevi. We observed changes with high specificity for the diagnosis of melanoma - asymmetric growth (Sp=90%), new structureless grey-blue areas (Sp=97.5%) or new grey-blue network (Sp=96.25%), new pseudopods or radial streaks (Sp=95%). Our study highlights highly specific changes whose presence should raise the suspicion of melanoma and lead to the excision of the lesion.